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Methicillin-resistant Staphylococcus aureus multiple sites surveillance: a systemic review of the literature

Authors Chipolombwe J, Török E, Mbelle N, Nyasulu P

Received 28 August 2015

Accepted for publication 23 October 2015

Published 12 February 2016 Volume 2016:9 Pages 35—42

DOI https://doi.org/10.2147/IDR.S95372

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Pardeep Kumar

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

John Chipolombwe,1 Mili Estee Török,2 Nontombi Mbelle,3 Peter Nyasulu,4,5

1Department of Internal Medicine, Mzuzu Central Hospital, Ministry of Health, Mzuzu, Malawi; 2Department of Medicine, University of Cambridge, Cambridge, UK; 3Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa; 4School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 5Department of Public Health, School of Health Sciences, Monash University, Johannesburg, South Africa

Purpose:
The objective of this study was to evaluate the optimal number of sampling sites for detection of methicillin-resistant Staphylococcus aureus (MRSA) colonization.
Methods: We performed a Medline search from January 1966 to February 2014 for articles that reported the prevalence of MRSA at different body sites. Studies were characterized by study design, country and period of the study, number of patients and/or isolates of MRSA, specimen type, sites of MRSA isolation, study population sampled, diagnostic testing method, and percentage of the MRSA isolates at each site in relation to the total number of sites.
Results: We reviewed 3,211 abstracts and 177 manuscripts, of which 17 met the criteria for analysis (n=52,642 patients). MRSA colonization prevalence varied from 8% to 99% at different body sites. The nasal cavity as a single site had MRSA detection sensitivity of 68% (34%–91%).The throat and nares gave the highest detection rates as single sites. A combination of two swabs improved MRSA detection rates with the best combination being groin/throat (89.6%; 62.5%–100%). A combination of three swab sites improved MRSA detection rate to 94.2% (81%–100%) with the best combination being groin/nose/throat. Certain combinations were associated with low detection rates. MRSA detection rates also varied with different culture methods.
Conclusion: A combination of three swabs from different body sites resulted in the highest detection rate for MRSA colonization. The use of three swab sites would likely improve the recognition and treatment of MRSA colonization, which may in turn reduce infection and transmission of MRSA to other patients.

Keywords: Staphylococcus colonization, swab sites, MRSA detection

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